# Increased Arrhythmia Risk in Long COVID: A Systematic Review and Meta‐Analysis

## TL;DR

Long COVID increases the risk of heart rhythm problems like atrial fibrillation and tachycardia, especially in those with severe initial infections.

## Contribution

This study provides the first meta-analysis showing a significant long-term arrhythmia risk in long COVID patients.

## Key findings

- Long COVID patients have a 74% higher risk of arrhythmias compared to non-infected individuals.
- Atrial fibrillation and ventricular arrhythmias show the highest increased risk in long COVID patients.
- Severe initial SARS-CoV-2 infections correlate with higher long-term arrhythmia risk.

## Abstract

COVID‐19 infection can cause significant long‐term health problems for patients. While there is no universally accepted definition for long COVID, it is usually identified by persistent symptoms that extend past 4 weeks after the initial SARS‐CoV‐2 infection with no other explanation. The cardiovascular system is one of the most important systems involved in long COVID, and even asymptomatic patients have evidence of cardiovascular injury after COVID‐19. This study aims to determine the long‐term risk of developing cardiac arrhythmias after SARS‐CoV‐2 infection.

A comprehensive systematic search on Scopus, PubMed, Science Direct, and Web of Science databases was performed on August 24th, 2025. Cohort articles consisting of a healthy control group with no history of COVID‐19 infection and individuals who recovered from COVID‐19 for at least 30 days were included. Hazard Ratio (HR) and 95% confidence intervals (CI) were estimated using random‐effect models.

Fourteen studies were eligible for the meta‐analysis. The overall arrhythmia risk was higher in patients with long COVID (HR: 1.74, 95% CI [1.39, 2.10], I
2 = 99.65%). Specific arrhythmias examined included atrial fibrillation (HR: 1.49, 95% CI [1.24, 1.73], I
2 = 98.57%), sinus tachycardia (HR: 1.69, 95% CI [1.21, 2.18], I
2 = 99.51%), sinus bradycardia (HR: 1.58, 95% CI [1.50, 1.66], I
2 = 65.80%), and ventricular arrhythmias (HR: 1.72, 95% CI [1.48, 1.95], I
2 = 96.89%). Patients with a more severe initial infection were at a higher risk of developing arrhythmias.

The risk of developing cardiac arrhythmias is increased after COVID‐19 infection in the long term.

This meta‐analysis included 14 studies. Long COVID was associated with a higher risk of atrial fibrillation, sinus tachycardia, sinus bradycardia, and ventricular arrhythmias. Patients with more severe COVID‐19 infection were at a higher risk of developing arrhythmias in the long term.